Application of Platelet-Rich Fibrin Transplantation for Large Macular Hole

Abstract

Purpose Large idiopathic macular hole (MH) has a lower closure rate and poor visual prognosis. To increase the closure rate and the visual outcome in patients with large MH, we evaluate a technique of platelet-rich fibrin (PRF) membrane transplantation for the treatment of large MH.

Methods This was a prospective interventional study. Seventeen eyes of 17 patients (8 males and 9 females) with large MH (654.94 ± 188.08 μm) underwent pars plana vitrectomy and internal limiting membrane peeling followed by PRF transplantation between January 2019 and December 2020. The patients were followed up for at least 6 months. Preoperatively and postoperatively, all patients underwent comprehensive ophthalmic examinations, including best-corrected visual acuity (BCVA), intraocular pressure, slit-lamp biomicroscopy, indirect ophthalmoscopy, ultra-widefield retinal imaging, optical coherent tomography, and optical coherent tomography angiography.

Results All the patients achieved complete and consistent hole closure after the surgery (100%). At 6 months follow-up, the external limiting membrane defects were observed in 3 eyes (17.64%), and the ellipsoid zone defects were observed in 10 eyes (58.82%). The preoperative BCVA was 1.21 ± 0.33 in logMAR. Postoperatively, the BCVA was significantly improved to 0.64 ± 0.22 in logMAR at 6 months (p < 0.001). The foveal avascular zone reduced significantly from 0.41 ± 0.08 mm² to 0.26 ± 0.07 mm² (p < 0.001). No complications were observed during or after the operation.

Conclusions All patients in this study have achieved good anatomic and functional results, which indicate that the application of PRF transplantation is an effective and safe technique for large MH.

Keywords:

• Macular hole
• platelet-rich fibrin
• transplantation
• closure rate
• safety

Acknowledgments

The study was not supported by any funding.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data are available on request due to privacy/ethical restrictions.